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- W4386886327 abstract "<h3></h3> Intelligent LFT (iLFT) was developed by NHS Tayside to enable further investigation of abnormal liver function test results on a single request from primary care. It combines demographics, clinical details and blood tests using an algorithm to generate a probable diagnosis and investigation/management plan. iLFT is indicated where there is suspicion of chronic liver disease, abnormal standard LFT, or abnormal ultrasound from Primary Care. Standard Liver Function tests and platelet count are performed, with patients with abnormal results cascaded to aetiological screen, and fibrosis scoring. Advice is offered on referral or Primary Care management, depending on the output from the algorithm, with patients with likely fibrosis being seen in a Nurse Led iLFT Assessment clinic for Fibroscan, Cardiovascular and Alcohol risk assessment and lifestyle advice. Patients with cirrhosis are commenced on primary prophylaxis for variceal haemorrhage and hepatoma surveillance as appropriate, prior to onward referral to Consultant liver clinic. iLFT was rolled out to pilot GP practices from January 2022, and fully in May 2022. We present our first year’s experience with iLFT, focussing on the impact of iLFT on secondary care triage of patients with abnormal LFTs. At the end of June 2023, we have had 1114 iLFT requests since launch, with some repeats because of platelet clumping or haemolysis. Of these 243 had initial results within iLFT cut-offs and 86 had an isolated raised ALP < 200, requiring no further testing. 785 requests had the full cascade carried out. A lot of work went into setting up laboratory algorithms, additional testing has also been generated. We used ELF to further stratify patients with high Fib-4 or NAFLD fibrosis scores. 52 of 271 ELF scores were <9.8, leading to a 19% reduction in referral. 63 patients have been seen in the Nurse led clinic, and x are still waiting. Of those assessed, 32 have been discharged, 10 followed up by fibroscan. Of 21 referred to Consultant clinic, 18 have Fibroscan >10kPa, 3 likely autoimmune liver disease. 9 new diagnoses of hepatitis C. iLFT can be rolled out in Primary care across other Boards. It allows reassurance of appropriate patients, with early diagnosis of significant liver disease. We have demonstrated collaboration between clinical and laboratory services in our board and NHS Tayside. iLFT can detect Hepatitis C, independent of risk based screening. We have confirmed the usefulness of a sequential approach to fibrosis assessment." @default.
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- W4386886327 date "2023-09-01" @default.
- W4386886327 modified "2023-09-27" @default.
- W4386886327 title "P89 Introduction of iLFT in NHS Fife" @default.
- W4386886327 doi "https://doi.org/10.1136/gutjnl-2023-basl.104" @default.
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